to refuse to take responsibility for student with anorexia nervosa?

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Leading on from discussion on another thread, this situation came up in my teaching career recently. I had a year 10 tutor group in a girls school, and was asked to undertake training on AN, to support one of my tutees.

I did attend the training, but did not complete it. It was "in person" in that I attended a central location where a trainer displayed power points and was available for questioning. It took a couple of hours, and I left before it was completed. The reason I left ( as did others) was because we felt that the whole thing was an exercise in passing The Buck to us, under the pretence that we were somehow prepared, able and competent to give medical support in the absence of any other medical support being available.

The training wasn't just AN, it was also other serious conditions, such as suicidal depression, OCD, body dysmorphia, etc

Some of the content was interesting and potentially helpful, but it was quite shocking, the feeling that we were going to be left in the lurch, not with our little bit of knowledge and understanding just improving feelings of welcome and acceptance for our charges, but somehow responsible for them medically.

I think parents have a very limited idea of what teacher training about medical issues consist of. I have over my career trained in more than 60 medical conditions, but nothing like this, in the past I have learnt danger signs like "if a child with asthma cant complete a sentence without drawing breath, call an ambulance". Or "try painting the wall that a child with ASD is facing blank pale pink, it might help" - or " a child with CP may work better on a vertical surface not a horizontal one" etc

not medical management, and not absolutes, just guidelines for safety and things to try only

I did not complete it, and did not allow my name to be recorded as having attended.

I still stand by that - a run through of a few power points does not make me a safely knowledgeable and qualified person for a child with AN to rely on

AIBU?

Plus a dozen more things that are dumped on them! Parents squabbling? Tell the school. Parking wars at home time? Tell the school. The list is almost endless, too much time is wasted trying to cover other people's responsibilities, especially parents' .

More and more teachers are being asked to provide support for students who self harm and report mental health difficulties. Beyond being kind and empathetic and reporting concerns this really isn't their job. Concerns that could very easily be serious illness or lead to students harming themselves need to be dealt with by professionals who are qualified to assess risk and support.

I work in a secondary school and liaise with CAMHS frequently as part of my role. There is no way that Teaching staff are being asked to weigh children with AN, measure their waists, monitor their calories or deliver any direct personal or medical care. This simply does not happen. You may have been asked to attend training giving an overview of these things, which are done by HCP's, for your awareness.

I agree that schools are increasingly being expected to plug the gaps left by other agencies due to shortages of staff and resources, and this is not right. But I do not believe that you have personally been asked to provide direct medical care and assistance for children with ED.

because, quite frankly, with 30-60 or so different medical conditions on the books at most large secondary schools most of the time, what do you think staff are going to do with what is effectively going to be a massive gurt medical text book! it is simply not realistic for all staff to be expected to be aware of all conditions at all times, even when you do train, it gets outdated very quickly, and new procedures and regimes come in!

I'm a teacher and I don't think most posters get how hard and how huge the responsibilities are in teaching. On another thread now running, there is a mother complaining that she finds it hard to care for her toddler at home besides doing a full time job at home. Everytime there is a thread like that it makes it so much harder to recruit teachers.
I heard a mother complaining recently that her year 1 daughter was on her fourth teacher this year. The original one had left to do law at Christmas and they can't replace her. So many parents don't get how unattractive teaching is becoming compared to wfh or hybrid jobs. Civil Service is so flexible with regards to working arrangements and so there is a big demand from people wanting the advantages of secure pensions with a very flexible job.
Its not all about the pay in teaching. It is about working conditions

This was all while on waiting list to be picked up by ED team, just to clarify

Also, should just clarify again, this isnt current, this was a situation last year.

Parents also ask school to intervene in their child's online arguments with other kids even when the students are posting and chatting in their own time under their parents supervision. It is time parents step up. Your kid is having problems online? Report any abuse to the online provider, block the other student or remove your child from the chat. I have lost count of the times a parent has sent me screen shots of a child swearing on WhatsApp or similar. It happened when the child was under their care. Parent is rude to you out of school tell the school. Child is left out of a party at the weekend, tell the school. Not everything should be laid at the school's door.

no, I would not, I am not a medical professional, and this is not my remit

What you've written makes no sense and if its actually true and you haven't taken the information about awareness too literally I hope a newspaper picks this story up as this should not be happening in a school setting by people with no medical training

You aren’t being asked to do anything just to be more informed, which you should be. What you need to know re AN isn’t going to change.

(Just as a warning, this may not be the best post to read if you have had an eating disorder as it contains discussion of purging etc.)

I've been a teacher at a school with students with eating disorders. At a stage in their recovery, we were asked to provide a space for some students to eat with supervision from a member of staff, in one case to ensure the student did not go to the toilet for an hour after eating because they would make themselves sick.

In some cases, the supervising staff were asked to check the students were not hiding food, rather than consuming it by checking parts of their clothing.

The school was put in a bit of a rock vs hard place situation as CAMHS was saying these children were well enough to be in school, so they couldn't access alternative provision easily, and (not that I think this is the important thing) it then causes problems with the school's absence figures if they aren't in school. So the head wanted them in school, and wanted staff to be involved in keeping them safe in this way.

But it's a huge responsibility. One of these children bounced through cycles of being hospitalised every few months, gaining enough weight to come back to school and then slowly deteriorating.

There's a difference between "this child has anorexia, or has been purging, so if they pass out, they need immediate medical attention as it may be their heart" or "this child is too ill to do PE", and the level of supervision schools are asked to offer in some places.

If nothing else, it needs to be facilitated by a member of staff who can give the student their full focus at every meal time, who won't leave the room, who has another break in their day to eat their own lunch, and go to the toilet etc! Because it's not the sort of situation where you can go "Oh, I'll just leave X for 2 minutes whilst I nip to the loo".

I'm all for staff in schools having awareness of behaviours that are risky around food, and I know some teens will restrict in school, but eat at home to hide the illness from their parents. But the level of supervision/involvement asked of school staff in some cases is very high.

Can I just clarify, I DID complete the AN part of the course, but not the whole course, which had many other mental health conditions included in it, so I did get all information available about my tutees condition

OP may well be being asked to supervise meals. This is sometimes asked of school staff, and it is a major responsibility which should not be under estimated.

Op I wasn’t having a go at you, I was asking questions to get a better picture as to why the LA was running this course. You mentioned later this was for a pupil last year who on was on an ED waiting list. Were they expecting you to run all these checks on the pupil until they were seen by qualified ED professionals?

It’s not a responsibility, my Dd has it. You just observe and feed back re seeing the food eaten or not. Nothing is on your shoulders. I do feel it shouldn’t cut into to reacher’s free time which is why senior staff do it at ours. We also do it outside in the car or Cahms do.

No, you dont get it!

I was being asked to take full responsibility for a child with a serious medical condition WHILE SHE WAS ON THE WAITING LIST for medical supervision, not alongside medical supervision, or in collaboration with her doctors, or ED team, or anything like that, but as a stop gap - for an indeterminate period.

Those of you thinking this is done under the supervision of an eating disorder team have completely missed the point - this is done because there is no supervision available from an eating disorder team

Anyway, I didnt do it, the training was in my free time, and there is no record I attended, so it never became my issue.

So what exactly were you asked to do?

And what was the name of the course?

I cant remember, something glib, "mental health in teens", or something like that the stated aim, to keep children safer while waiting medical supervision.

I’ve always had a simple line I do not cross- if I feel the child is at risk I do not agree to manage the condition. If it’s beyond either my capabilities, or if I don’t have the time to safely manage needs

Very wise, HedgeWitchy; you're also correct that piling unrealistic expectations on staff helps nobody in the end, though doubtless it gets the problem "off the books" for a while, which is all the shortsighted appear to care about

There's also the possibility of manipulation here, as in "Well all the other schools are onboard", etc, but more likely - having delivered their "course" - it'll be forgotten about in favour of the next "initiative"

Right up to the point when something goes wrong and the search starts for a scapegoat ...

I don't blame you.

That child deserves proper medical care, and you deserve to be able to do your job with out having to play nurse too.

Its not fair on the student or teacher.

Because asking you to measure waists and weigh as you listed is massively invasive, triggering and wrong. I can’t believe any course provider would suggest that.

Schools can (and many do) refuse to do this. At the school where I work if a child with AN is not well enough that they can complete a meal independently then a parent or relative has to come in and supervise them or take them off site to eat. Our staff are all busy at lunchtimes delivering interventions, doing playground duty, answering phones or responding to incidents. There is no way we could guarantee this provision consistently, CAMHS and the vast majority of parents understand this.

Maybe you could look it up as it clearly resonated strongly.

What exactly did they ask you to do?

I don't understand how walking out of the training is more valuable and beneficial to the tutee than completing it. Neither means you become medically responsible - you can still refuse to take action in everyday settings. But hey, you already left.

I used to work in a school in a pastoral role whereby my whole responsibility was first aid and the management of health conditions in school. For me it would have involved a care plan devised by myself, which is quite ridiculous considering I am not a HCP. Usually lots of meetings with the parents so they can see the care plan and sign it and potentially having a discussion with the school nurse about it. I did leave this job as it was in my opinion a bit shambolic. I felt vulnerable and open to allsorts.